Individual
IBOCWA PHILLIP MLONGECHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 WASHINGTON ST, BRAINTREE, MA 02184-4729
(781) 843-3853
Mailing address
57 ELIOT RD, REVERE, MA 02151-5419
(857) 505-8524
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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